Our series, Hormones & Our Health: How What You Eat May Affect How They Work, explores the vast role hormones play in the body and the diet and lifestyle factors that help them function as they should.
Hormonal health is gaining traction in the health and wellness world as people learn more about exactly what hormones do in our bodies. On EatingWell.com and its sister site, Health.com, interest in articles around hormones rose 48% and 73% (respectively) just in the past year. And according to Melissa Groves Azzaro, RDN, LD, CEO and founder of The Hormone Dietitian LLC, hormonal issues are becoming more common as diagnosis for conditions such as polycystic ovary syndrome (PCOS), endometriosis, fibroids and infertility continue to increase, in addition to other hormone-related conditions, like diabetes. This increase is partly due to diagnostic advances as well as individuals' own understanding of the associated symptoms.
While we may initially think of estrogen and testosterone (the sex hormones) when we think of hormones, there's a lot more to hormones than just those two. Hormones are responsible for just about every aspect of daily life, from sleep to digestion and metabolism, stress management and energy levels. As we age, some hormone levels naturally shift, which is why things like menopause happen in the first place. But besides menopause, what else happens to our hormones at different life stages? To help you better understand your hormones—and ultimately your health—we talked to endocrinologist Arti Thangudu, M.D., about the significant changes that happen to some of the well-known hormones during different parts of the lifespan.
What Happens to Your Hormones As You Age
According to Thangudu, research hasn't shown significant effect of aging on hormones like leptin (the fullness hormone) and ghrelin (the hunger hormone) and, ultimately, we don't see levels of these change all that much in our 20s, 30s, 40s and so on. On the other hand, research around estrogen and testosterone, in particular, as well as insulin, cortisol and melatonin, suggests otherwise—even if you haven't been diagnosed with a hormone-related condition. These hormone changes are all normal parts of the aging process and while they may play a role in disease development, there certainly are eating and lifestyle habits you can adopt throughout life to help keep you healthy as you age (more on that later). And, of course, it's always beneficial to speak with your doctor to find relief from concerning symptoms.
Your Hormones in Your 20s
Testosterone levels likely have already reached their peak by 18 to 20 years old in cisgender men and some transgender people, whereas estrogen levels reach their peak in the mid to late 20s for cisgender women and some transgender people. Melatonin, or the "sleep hormone," reaches its peak way earlier, with some research suggesting it peaks between 2 and 5 years of age. While there's still plenty to help you get adequate shut-eye for the next few decades, melatonin levels continue to decline gradually over the lifespan, a decline that may be related to sleep troubles later in life.
Your Hormones in Your 30s
According to a study in the Journals of Gerontology, we start to see circulating testosterone levels in cisgender men and some transgender people decrease around 35 to 40 years of age by 1 to 3% per year. This gradual decrease may bring some symptoms, like changes in muscle and fat mass or decreased libido, but often those symptoms are seen more in older age. Similarly, levels of estrogen and progesterone (another sex hormone) continue to gradually decline in your 30s in cisgender women and some transgender people, which is most often marked with changes to the menstrual cycle. Changes differ from person to person and the menstrual cycle may become shorter, longer, heavier or lighter.
In terms of the "stress hormone," cortisol, another study from the Journals of Gerontology looked at cortisol levels in approximately 1,800 people over the course of 31 years, finding that levels generally decrease in your 20s and 30s, remain stable in your 40s and 50s and increase thereafter. The decrease in cortisol is partly due to the reduced fight-or-flight response young people have to outside stressors, plus self-perceived stress tends to decrease and coping mechanisms tend to increase throughout those years. Of course, it also depends on individual life stressors.
Your Hormones in Your 40s
The mid to late 40's is when cisgender women and some transgender people may expect to experience perimenopause, which is the time leading up to your last period where estrogen and progesterone levels vary from month to month. These hormone changes can cause irregular periods and may also bring menopause symptoms like hot flashes, weight changes, mood changes and, according to the Journal of Women's Health, sleep pattern disturbances. However, it's not entirely clear if perimenopause or menopause are fully to blame for sleep problems or if increasing sleep problems are more related to aging in general and the natural decline in melatonin.
While testosterone levels continue to decline in cisgender men and some transgender people, most are still years away from andropause (sometimes called "male menopause"), which is when we see testosterone levels dip more dramatically.
Your Hormones in Your 50s
Estrogen declines by approximately 50% by 50 years of age and dramatically decreases further after menopause in cisgender women and some transgender people. According to the Mayo Clinic, the average age of menopause in the U.S. is 51, but individuals can experience it at different times throughout their 40s or 50s. The decline in estrogen is associated with subsequent declines in muscle mass and strength, decreased libido, hot flashes, mood changes, fatigue, weight changes and joint pain, as well as a higher risk for osteoporosis.
Menopause and its connection to cancer is still confusing to some. Your risk for cancer increases as you age, but menopause does not cause cancer. Generally, a longer lifetime exposure to estrogen increases a person's risk of breast cancers, but it's not the only factor involved in cancer development.
Additionally, estrogen can act as an anti-inflammatory in the body, so lower levels of it during and after menopause can mean an increase in low-grade inflammation. This inflammation may contribute to conditions like atherosclerosis (or plaque buildup in the arteries), cardiovascular diseases, metabolic syndrome and type 2 diabetes. The same can be said for lower testosterone levels. All the more reason to adopt an anti-inflammatory Mediterranean style of eating!
Your Hormones in Your 60s and Beyond
Andropause, is when testosterone levels begin to drop off more rapidly in cisgender men and some transgender people, which we often see starting around age 60. The most obvious signs related to this drop in testosterone include changes in muscle mass and strength, a decrease in bone mass and an increase in central body fat. As a result, people may experience balance problems, more falls and injuries related to increased osteoporosis and chronic conditions, like sleep apnea, depression, obesity, heart disease, type 2 diabetes and potentially renal or liver diseases.
It's in these later years where we see body mass changing as part of the natural aging process that we also see changes in insulin sensitivity, or how effective your body is at responding to insulin. Whether or not you have diabetes, research suggests that a decrease in insulin sensitivity is less related to age and more related to an increase in fat mass. So, maintaining a healthy weight as you age can be protective.
Now, back to the study that looked at cortisol levels as you age. The study did control for numerous health-related factors and suggests that the increasing cortisol levels over time may have to do with the increasing disease burden with age (both physically, emotionally and even financially), age-related increases in cytokines (or pro-inflammatory compounds) or other naturally occurring factors that come with age. Again, this is highly dependent on individual stress levels, but the research is all the more evidence to encourage an anti-inflammatory style of eating, especially as we age.
How to best support hormones—and overall health—as you age
So, what should you do with all of this information? While hormone levels naturally change over time, there are some steps you can take to lessen the impact.
1. Work with your doctor to find relief from troublesome symptoms
Learning to pay attention to your body early on to be able to notice any changes can be key to identifying issues before they get out of control. The effects of hormonal changes differ from person to person. For some, it may present as a minor concern, while for others it can be of such significance that it causes disruptions to daily living, says LaKeischa McMillan, M.D., a gynecologist and hormone specialist. Symptoms such as weight fluctuations, fatigue, persistent joint pain, low libido, heart rate fluctuations, changes in bowel movements and even depression are some that should be concerning enough for you to contact your medical provider.
2. Adopt a Mediterranean-style diet
With the natural increase in inflammation that happens as you age, it's beneficial—and delicious—to incorporate the principles of the Mediterranean diet. This way of eating has been praised for its ability to help protect your heart and brain as you age, decrease risk for diabetes, make losing weight and maintaining a healthy weight easier and much more. And unlike most diets, it doesn't suggest excluding any one particular food or food group.
When people think of foods affecting their body, they tend to focus on what they need to stop eating as opposed to the things they're not eating enough. For example, carbohydrates are often frowned upon, especially as part of trendy weight-loss diets, but according to Azzaro, carbohydrates are "crucial for a healthy reproductive hormone response," in addition to just about every other bodily function. And your body needs cholesterol and fat to adequately produce hormones, so it's important to focus on incorporating healthy sources of fat in your diet as well.
And best of all, the Mediterranean diet is easy to follow, which helps cut down on life's stress.
3. Watch out for hormone-disrupting chemicals
The toxins you're exposed to in the environment also play a major role in hormone health. Azzaro notes that chemicals known as xenoestrogens can mimic or even change the actions of our hormones. As a protective measure, she recommends limiting exposure to hormone-disrupting chemicals, such as plastics made with BPA (bisphenol A) and phthalates, pesticides, as well as certain beauty and cleaning products that contain ingredients like triclosan.
4. Decrease stress
We all know how detrimental stress can be on our health. And because cortisol levels naturally increase as we age, we'll want to combat that stress through healthy diet and lifestyle habits, while also working to eliminate sources of stress from our lives where we can.
5. Incorporate strength training
Despite what you may think, cardio isn't everything. While it's important to get your heart pumping with comfortable-to-you cardio exercises, because muscle mass and bone density decrease as we age, incorporating strength training may be even more beneficial.
Bottom line
Some hormone changes are a natural part of aging, and while some symptoms can be uncomfortable to deal with, there are ways to help mitigate their impact. And remember, it's always a good idea to speak with your doctor about any concerning symptoms.
We at EatingWell understand that most studies, including the ones we reference in this article, are based on what happens to hormone levels in cisgender people whose gender aligns with the one assigned to them at birth. This is especially true when referring to sex hormones. We adjusted our language to be sure to include all identities but recognize that based on a person's use of gender-affirming puberty blockers or hormone therapy, some of this information may not apply to transgender and nonbinary individuals in the most comprehensive way it should. We also recognize that not all transgender and nonbinary people use hormones as part of their care.
